HomeMy WebLinkAboutFire Service/Self Audit 06
MUNIID: 70266
FIRE ID: 70030
CITY CLERK'S OFFIC
ction A: Fire Protection Services
Under Section COMM 14.48 (3) (c) cities, villages or towns must certify whether or not they are providing fire
protection services by indicating they are in substantial compliance with the following requirements. (Place an
X below in the box by the correct answer. Choose only one answer for each question)
1 The fire department is organized to provide continuous fire protection in that city, village or town. - Required by
s.101.575 3 a 1., Stats.
2 The fire de artment has a desi nated fire chief. - Re uired b : s.1 01.575 3 a 1., Stats.
3 Singly, or in combination with another fire department under a mutual aid agreement, the fire department must
ensure the response of at least 4 firefighters, none of whom is the chief, to a first alarm for a building. - Required
b s. 101.575 3 a 2., Stats.
4 The fire department must provide a firefighter safety and health training program as prescribed by Chapter Comm
14. - Re uired b s. 101.575 3 a 3., Stats
5 The fire department has facilities capable, without delay, of receiving an alarm and dispatching firefighters and
a paratus. - Required b s. 101.575 3) a) 4., Stats
6 If the fire department is a volunteer fire department, it must hold a meeting at least once each month, or a paid or
partly-paid fire department must ensure sufficient personnel ready for service at all times. - Required by: s.
101.575 3 b, Stats.
7 The city, village or town must ensure that for the calendar year of 2005, the fire department dues money was only
used for one or more of the following:
. The purchase of fire protection equipment.
. Fire inspection and public education.
. Training of firefighters and fire inspectors performing public fire education and fire prevention inspection.
. To fund wholly or partially firefighters' pension funds or other special funds for the benefit of disabled or
su erannuated fireti hters. - Re uired b : s. 101.575 6 a, Stats
Was the subject municipality in substantial compliance with the regulations in Section A? ves[R] NoD
Self-Certification Audit Si nature Section
I, the undersigned, hereby certify that the substantial compliance indicated on this self-certification audit form is true. I am signing this
document in my capacity as the clerk for: CITY OF OSHKOSH
County:WINNEBAGO
Municipal 10 Code:70266
Clerk name.: PAMELA R. UBRIG
Work phone number:(920) 236-5014
clerk
Clerk signature:i)CU
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I, the undersigned, hereby certify that the substantial compliance indicate'd on this self-certification audit form is true. I am signing this
document in my capacity as the fire chief for: OSHKOSH FIRE DEPT
Chief name.: TIMOTHY FRANZ FDID:70030 Pay status: 1
*Note: ......... .If the fire chief name listed above is not the name of the person signing below, then please print the full name of the person signing, the
work phone number, check the appropriate status box and fill in the effective date.
Work phone number:
o A pointed or elected chief Effective date:
Name:
Fire chief signature: I '-
/:2
Date: 4~~- Go (;
MUNIID: 70266
FIRE ID: 70030
CITY CLERK'S OFEIC
ction A: Fire Protection Services
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Under Section COMM 14.48 (3) (c) cities, villages or towns must certify whether or not they are providing fire
protection services by indicating they are in substantial compliance with the following requirements. (Place an
X below in the box by the correct answer. Choose only one answer for each question)
1 The fire department is organized to provide continuous tire protection in that city, village or town. - Required by
s.101.575 3 a 1., Stats.
2 The fire de artment has a desi nated fire chiet. - Re uired b : s.1 01.575 3 a 1., Stats.
3 Singly, or in combination with another fire department under a mutual aid agreement, the fire department must
ensure the response of at least 4 firefighters, none of whom is the chief, to a tirst alarm tor a building. - Required
b s. 101.575 3 a 2., Stats.
4 The fire department must provide a firefighter safety and health training program as prescribed by Chapter Comm
14. - Re uired b s. 101.575 3 a 3., Stats
5 The tire department has facilities capable, without delay, of receiving an alarm and dispatching firetighters and
apparatus. - Required by s. 101.575 (3) a) 4., Stats
6 It the fire department is a volunteer fire department, it must hold a meeting at least once each month, or a paid or
partly-paid fire department must ensure sufficient personnel ready for service at all times. - Required by: s.
101.575 3 b, Stats.
7 The 'city, village or town must ensure that for the calendar year of 2005, the fire department dues money was only
used for one or more of the following:
· The purchase ot fire protection equipment.
. Fire inspection and public education.
· Training of firefighters and fire inspectors performing public fire education and fire prevention inspection.
· To fund wholly or partially 'firefighters' pension funds or other special funds tor the benefit of disabled or
su erannuated fireti hters. - Re uired b : s. 101.575 6 a, Stats
Was the subject municipality in substantial compliance with the regulations in Section A? ves[R] NoD
Self-Certification Audit Si nature Section
I, the undersigned, hereby certify that the substantial compliance indicated on this self-certification audit form is true. I am signing this
document in my capacity as the clerk for: CITY OF OSHKOSH
County:WINNEBAGO
Municipal 10 Code:70266
Clerk name.: PAMELA R. UBRIG
Work phone number:(920) 236-5014
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I, the undersigned, hereby certify that the substantial compliance indicated on this self-certification audit form is true. I am signing this
document in my capacity as the fire chief for: OSHKOSH FIRE DEPT
Chief name.: TIMOTHY FRANZ
FDID:70030
Pay status: 1
Fire chief signature: I '-
/-:2
Date: 4~~- Go (;
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